Please select the location of your most recent visit to our practice.

This survey will take less than five minutes to complete.

Please select the survey.

This survey will take less than five minutes to complete.

Doctor [1 of 13]

Provider:
Location:  

1. When you called for an appointment, were you satisfied with the response from the person who answered the telephone?

Doctor [2 of 13]

Provider:
Location:  

2. When you arrived at the office, did you find the receptionist to be:

Doctor [3 of 13]

Provider:
Location:  

3. How acceptable was the amount of time spent in the reception area and examining room, before seeing the doctor?

Doctor [4 of 13]

Provider:
Location:  

4. Please check the reason you came to our office (please click all that apply):

Doctor [5 of 13]

Provider:
Location:  

5. During your examination, did you find the doctor to be:

Doctor [6 of 13]

Provider:
Location:  

6. When you saw the doctor, were you satisfied that he/she spent an appropriate amount of time with you, answered your questions, and explained medical procedures and treatments to your satisfaction?

Doctor [7 of 13]

Provider:
Location:  

7. How satisfied were you with the doctor's diagnosis and treatment recommendations?

Doctor [8 of 13]

Provider:
Location:  

8. How satisfied are you with the follow-up visit after wearing the new hearing aid(s) in daily life?

Doctor [9 of 13]

Provider:
Location:  

9. How satisfied are you with the fitting of the hearing aid(s) to your ear by the audiologist?

Doctor [10 of 13]

Provider:
Location:  

10. When asking billing/insurance questions, did you find our billing/insurance staff to be:

Doctor [11 of 13]

Provider:
Location:  

11. Please rate your overall experience with our practice:

Doctor [12 of 13]

Provider:
Location:  

12. Would you recommend our practice to your friends?

Doctor [13 of 13]

Provider:
Location:  

13. Please provide any additional comments.